Çocukluk çağı akut immun trombositopeni olgularında farklı tedavi protokollerinin değerlendirilmesi

Abstract

Objective: The aims of this retrospective study were to compare the results of therapeutic efficacy of intravenous high^ dose methylprednisolone (HDMP) and intravenous immunoglobulin (WIG) for the treatment and to determine of demographic characteristics of cases. Methods: Data were collected from hospital medical records between January 1998 and February 2003. We evaluated 50 cases (23 male, 27 female), aged between 1-14 years, diagnosed as acute immune idiopathic thrombocytopenic purpura. 24 cases were treated with HDMP, 15 cases with WIG',11 cases whom the consecutive therapy was started because of inadequate elevation in platelet counts therapies. At the end of 48 hours and 72 hours of therapy, platelet counts were determined. Results: After 48 hours of treatment, mean platelet counts were determined as 44x10(9)/L in the group who received HDMP, 55 x 10(9)/L in the group given MG and 17x10(9)/L in the group given consequtive tretment. After 72 hours of treatment, mean platelet counts were determined as 83x10(9)IL in the group who received HDMP, 110x10(9)/L in the group given WIG and 21 x 10(9)IL group given consequtive tretment. The time required to platelet counts increased at a level of > 50 xlO(9)/L was 3.6±1.5 days in the group who received HDMP, 2.5±0.8 in the group who received WIG, 10.8±4.6 days in the group who received consequtive treatment. Chronic immune thrombocytopenic purpura (ITP) developed in 8% of children who received HDMP, 13% of children who received IVIG, 54% of children who received consequtive treatment. Conclusion: When assessing the effectivity of WIG and HDMP therapy in the treatment of acute ITP we found no difference between these two modalities. In patients by whom the consecutive therapy was started because of inadequate elevation in platelet counts, the risk of developing chronic ITP was increased.